title: Long-term outcome and cost-effectiveness of complete versus assisted video-assisted thoracic surgery for non-small cell lung cancer.
abstract: BACKGROUND
  To compare the outcomes and costs of two methods of video-assisted thoracoscopic surgery (VATS) major pulmonary resection in patients with clinically resectable non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Between January 2000 and December 2007, 1,058 patients with proven stages I-IIIA NSCLC underwent complete VATS (c-VATS) or assisted VATS (a-VATS) major pulmonary resection together with a systematic nodal dissection.
  
  
  RESULTS
  The study cohort consisted of 736 men and 322 women. Mean operative time was shorter for the a-VATS cohort compared with the c-VATS group (P = 0.038). Overall survival (OS) at 5 years based on Kaplan-Meier analysis was 55.3% (95%CI, 50.6-60.0%) for those who underwent c-VATS and 47.7% (95%CI, 41.2-54.2%) for those who underwent a-VATS (P = 0.404). Gender, final pathology, TNM stage, and pT status were significant predictive factors for OS according to multivariate analysis. The total cost of a-VATS lobectomy was lower than that of c-VATS lobectomy.
  
  
  CONCLUSIONS
  c-VATS and a-VATS yield similar results in patients with clinically resectable NSCLC. a-VATS, however, may be less expensive and easier to adopt, making it a particularly attractive option for thoracic surgeons in developing countries.
authors.affiliation: Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China. drjianxing.he@gmail.com
authors.forename: Jianxing
authors.initials: J
authors.lastname: He
authors.forename: Wenlong
authors.initials: W
authors.lastname: Shao
authors.forename: Christopher
authors.initials: C
authors.lastname: Cao
authors.forename: Tristan
authors.initials: T
authors.lastname: Yan
authors.forename: Daoyuan
authors.initials: D
authors.lastname: Wang
authors.forename: Xin-Guo
authors.initials: XG
authors.lastname: Xiong
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Yin
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.forename: Hanzhang
authors.initials: H
authors.lastname: Chen
authors.forename: Yuan
authors.initials: Y
authors.lastname: Qiu
authors.forename: Baoliang
authors.initials: B
authors.lastname: Zhong
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000191:economics* / Q000379:methods; D020775:Thoracic Surgery, Video-Assisted / Q000191:economics* / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome